Diverse and Special Needs Populations

As has been emphasized repeatedly in the professional literature and throughout
this protocol, sex offenders are a diverse group of individuals with a wide
range of unique needs to which treatment interventions must be responsive.
Among other key factors, this diversity relates to culture and gender. For
example, gender–responsive treatment programs must be developed for female
sex offenders, based on an understanding of the unique risks and needs of justice–involved
women and adolescent girls (see, e.g., CSOM, 2007). In addition, staff training
and client programming may need to be tailored to address special needs populations
such as hearing– or visually–impaired clients, individuals with
low cognitive functioning, those with serious and persistent mental illness
or medical disabilities, or incarcerated offenders in protective custody or
segregation status. Although it is beyond the scope of this protocol to review
treatment approaches or other management strategies for diverse and special
needs populations, the importance of taking into account these critical issues
must be emphasized for all who have a role in sex offender management. Unfortunately,
this is an area that remains considerably underdeveloped within the research
and practice literature (see Haaven, Little, & Petre–Miller, 1990;
Laws, Hudson, & Ward, 2000; Longo & Prescott, 2006; Marshall, Fernandez,
Hudson, & Ward, 1998; and O’Reilly, Marshall, Carr, & Beckett,
2004 for reviews of interventions with several special populations).

Another special population in some jurisdictions is the group of high risk
sex offenders who have been civilly committed. Under this scheme, individuals
determined to have a mental abnormality that predisposes them to commit sexually
violent or predatory offenses, who are unable to control their behaviors, and
who are determined to pose a high risk to reoffend are committed through civil
proceedings at the expiration of their prison sentences. This is an area of
controversy because of constitutional questions, high operational costs, limited
numbers of releases, differing policies and practices, and a lack of evidence–based
guidance for programs (see, e.g., Janus, 2006; LaFond, 2005; Schlank, 2001;
Schlank & Cohen, 1999; Winick & LaFond, 2003). Specialized policy
and practice considerations must, at a minimum, take into account the following:

Notice to incarcerated sex offenders about the civil commitment statute
and its potential relevance to their status;

The screening and referral process;

Approaches to forensic evaluations for commitment proceedings;

The type of treatment(s) to be offered for those who are ultimately committed;

Treatment planning and the assessment of treatment progress;

Assessment of changes in risk over time;

Release decisionmaking; and

Transition and reentry planning.

Given the unique issues associated with this management strategy, jurisdictions
considering civil commitment should carefully review the available research,
practice literature, and relevant case law, and consult with states who have
engaged in rigorous policy analysis and program implementation relative to
this special population.